The Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA.
Atlanta Diabetes Associates, Atlanta, GA, USA.
Cardiovasc Ther. 2018 Feb;36(1). doi: 10.1111/1755-5922.12308. Epub 2017 Nov 25.
Two multiple-dose phase II studies were conducted in subjects with primary hypercholesterolemia to evaluate the LDL-C lowering efficacy, safety, and tolerability of bococizumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor.
The results from the two phase II, double-blinded, randomized, placebo-controlled, multicenter studies conducted in the USA and Canada were combined. In Study 1, 90 subjects with LDL-C ≥100 mg/dL received intravenous (IV) placebo or bococizumab 0.25, 1, 3, or 6 mg/kg. In Study 2, 45 subjects with LDL-C ≥80 mg/dL received IV placebo or bococizumab 1 or 3 mg/kg. Subjects were treated every 4 weeks for 12 weeks. Dosing was interrupted if LDL-C dipped to ≤25 mg/dL and resumed if LDL-C returned to ≥40 mg/dL. The primary endpoint was percent LDL-C reduction from baseline at Week 12.
At Week 12, the reductions from baseline in LDL-C vs placebo in the bococizumab 0.25, 1, 3, and 6 mg/kg groups were 9.3%, 10.2%, 41.6%, and 52.0%, respectively (P < .001 vs placebo for all). LDL-C reductions were greater (69.9%) in subjects who received all three doses of bococizumab 6 mg/kg (P < .001 vs placebo). Pharmacogenomic analysis revealed that 15% of hyperlipidemic subjects carried polymorphisms associated with familial hypercholesterolemia, with maximal LDL-C reductions being similar between carriers and noncarriers. Adverse events were mild, unrelated to bococizumab, and resolved by Week 12.
These studies demonstrated that bococizumab safely and effectively lowered LDL-C in hypercholesterolemic subjects on high doses of statin.
两项在原发性高胆固醇血症患者中进行的多剂量 II 期研究评估了 bococizumab(一种前蛋白转化酶枯草溶菌素/激肽释放酶 9(PCSK9)抑制剂)降低 LDL-C 的疗效、安全性和耐受性。
将在美国和加拿大进行的两项 II 期、双盲、随机、安慰剂对照、多中心研究的结果进行了合并。在研究 1 中,90 名 LDL-C≥100mg/dL 的受试者接受静脉(IV)安慰剂或 bococizumab 0.25、1、3 或 6mg/kg。在研究 2 中,45 名 LDL-C≥80mg/dL 的受试者接受 IV 安慰剂或 bococizumab 1 或 3mg/kg。受试者每 4 周治疗 12 周。如果 LDL-C 降至≤25mg/dL,则中断给药,如果 LDL-C 恢复至≥40mg/dL,则恢复给药。主要终点是第 12 周时 LDL-C 从基线的降低百分比。
第 12 周时,与安慰剂相比, bococizumab 0.25、1、3 和 6mg/kg 组的 LDL-C 降低分别为 9.3%、10.2%、41.6%和 52.0%(所有 P<.001 )。接受 bococizumab 6mg/kg 所有三种剂量的受试者(69.9%)的 LDL-C 降低幅度更大(P<.001 )。药物基因组学分析显示,15%的高脂血症患者携带与家族性高胆固醇血症相关的多态性,携带者和非携带者之间的最大 LDL-C 降低幅度相似。不良事件为轻度,与 bococizumab 无关,并在第 12 周时得到解决。
这些研究表明,在高剂量他汀类药物治疗的高胆固醇血症患者中, bococizumab 安全有效地降低了 LDL-C。